Provider Demographics
NPI:1326867532
Name:DABNEY, SHAVETTA DONNETTA
Entity type:Individual
Prefix:
First Name:SHAVETTA
Middle Name:DONNETTA
Last Name:DABNEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4485 ELDERBERRY ST
Mailing Address - Street 2:
Mailing Address - City:FORNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75126-0719
Mailing Address - Country:US
Mailing Address - Phone:469-630-4937
Mailing Address - Fax:
Practice Address - Street 1:4485 ELDERBERRY ST
Practice Address - Street 2:
Practice Address - City:FORNEY
Practice Address - State:TX
Practice Address - Zip Code:75126-0719
Practice Address - Country:US
Practice Address - Phone:469-630-4937
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-04
Last Update Date:2024-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX20506246RP1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy